<!DOCTYPE html>
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8">
<title>Untitled</title>
<link rel="stylesheet" href="__PUBLIC__/Green/css/global.css" />
<link href="__PUBLIC__/Green/css/bootstrap.css" rel='stylesheet' type='text/css' />
<script src="__PUBLIC__/Green/js/jquery-1.11.0.min.js"></script>
</head>
<body>
  <form id="frm" name="form" action="__SELF__">
      <div class="form-group">
        <label for="c_dpt_cde">市区代码</label>
        <input type="text" class="form-control" id="c_dpt_cde" name="c_dpt_cde" placeholder="市区代码">
      </div>
      <div class="form-group">
        <label for="c_order_no">订单号</label>
        <input type="text" class="form-control" id="c_order_no" name="c_order_no" placeholder="订单号">
      </div>
      <div class="form-group">
        <label for="t_insrnc_bgn_tm">商业险-保险起期</label>
        <input type="text" class="form-control" id="t_insrnc_bgn_tm" name="t_insrnc_bgn_tm" placeholder="商业险-保险起期">
      </div>
      <div class="form-group">
        <label for="t_traff_bgn_tm">交强险-保险起期</label>
        <input type="text" class="form-control" id="t_traff_bgn_tm" name="t_traff_bgn_tm" placeholder="交强险-保险起期">
      </div>
      <div class="form-group">
        <label for="fuel_type">能源种类</label>
        <input type="text" class="form-control" id="fuel_type" name="fuel_type" placeholder="能源种类">
      </div>
      <div class="form-group">
        <label for="buy_date">购车发票开具日期0-9个月的必填</label>
        <input type="text" class="form-control" id="buy_date" name="buy_date" placeholder="购车发票开具日期0-9个月的必填">
      </div>
      <div class="form-group">
        <label for="verfycode">TOKEN</label>
        <input type="text" class="form-control" id="token" name="token" value="{$token}">
      </div>
      <input type="hidden" name="kinds[030006][c_kind_cde]" value="030006"> 
      <input type="hidden" name="kinds[030006][n_amt]" value="168840"> 
      <input type="hidden" name="kinds[030006][n_seatnum]" value=""> 
      
      <input type="hidden" name="kinds[031901][c_kind_cde]" value="031901"> 
      <input type="hidden" name="kinds[031901][n_amt]" value="0"> 
      <input type="hidden" name="kinds[031901][n_seatnum]" value="">
      
      <input type="hidden" name="kinds[030018][c_kind_cde]" value="030018"> 
      <input type="hidden" name="kinds[030018][n_amt]" value="200000"> 
      <input type="hidden" name="kinds[030018][n_seatnum]" value="">
             
      <input type="hidden" name="kinds[031902][c_kind_cde]" value="031902"> 
      <input type="hidden" name="kinds[031902][n_amt]" value="0"> 
      <input type="hidden" name="kinds[031902][n_seatnum]" value="">
       
      <button type="submit" class="btn btn-default">递交</button>
  </form>
<script type="text/javascript" src="__PUBLIC__/Green/js/jquery.validate.min.js"></script>
<script type="text/javascript">
$('#frm').validate({
            submitHandler:function(form){
                $.post("__SELF__",$(form).serialize(),function(data){
                    if(data.status){
                       alert(data.info);
                    }else{
                        alert(data.info);
                    }
                },'json');
            } 
        });
</script>
</body>
</html>
